EP2292172B1 - Elektrochirurgische Elektrode mit Isolierbeschichtung - Google Patents

Elektrochirurgische Elektrode mit Isolierbeschichtung Download PDF

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Publication number
EP2292172B1
EP2292172B1 EP10175050A EP10175050A EP2292172B1 EP 2292172 B1 EP2292172 B1 EP 2292172B1 EP 10175050 A EP10175050 A EP 10175050A EP 10175050 A EP10175050 A EP 10175050A EP 2292172 B1 EP2292172 B1 EP 2292172B1
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EP
European Patent Office
Prior art keywords
electrode
electrosurgical
distal end
edges
insulative material
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Not-in-force
Application number
EP10175050A
Other languages
English (en)
French (fr)
Other versions
EP2292172A1 (de
Inventor
William J. Dickhans
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Covidien LP
Original Assignee
Tyco Healthcare Group LP
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Tyco Healthcare Group LP filed Critical Tyco Healthcare Group LP
Publication of EP2292172A1 publication Critical patent/EP2292172A1/de
Application granted granted Critical
Publication of EP2292172B1 publication Critical patent/EP2292172B1/de
Not-in-force legal-status Critical Current
Anticipated expiration legal-status Critical

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/148—Probes or electrodes therefor having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00059—Material properties
    • A61B2018/00071—Electrical conductivity
    • A61B2018/00083—Electrical conductivity low, i.e. electrically insulating
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00107—Coatings on the energy applicator
    • A61B2018/0013—Coatings on the energy applicator non-sticking
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1422—Hook

Definitions

  • the present disclosure relates to an electrosurgical electrode and, more particularly, to an electrosurgical electrode including an insulative coating configured to provide a path for electrosurgical energy from the electrosurgical electrode to tissue during an electrosurgical procedure.
  • Electrosurgical instruments have become widely used by surgeons in recent years.
  • electrosurgical instruments are hand-held instruments, e.g., an electrosurgical pencil, which transfer radio-frequency (RF) electrical or electrosurgical energy to a tissue site via an electrosurgical electrode.
  • RF radio-frequency
  • the electrosurgical energy is returned to the electrosurgical source via a return electrode pad positioned under a patient (i.e., a monopolar system configuration) or a smaller return electrode positionable in bodily contact with or immediately adjacent to the surgical site (i.e., a bipolar system configuration).
  • the waveforms produced by the RF source yield a predetermined electrosurgical effect known generally as electrosurgical cutting and fulguration.
  • electrosurgical electrodes configured for electrosurgical use are subject to high temperatures at least where an electrosurgical arc emanates during the electrosurgical procedure, e.g., fulguration or coagulation.
  • the heat generated by the electrosurgical electrode during an electrosurgical procedure may cause proteins in bodily fluids and/or tissue to coagulate and adhere to the electrodes.
  • an insulative coating e.g., a Teflon polymer, may be applied to the electrosurgical electrode.
  • areas of the electrosurgical electrode covered with an insulative coating cannot transmit RF electrical or electrosurgical energy to a tissue site.
  • WO 01/64122 discloses an electrosurgical blade with a non-stick coating wich will vaporize on the sharp edges, where the coating is thin upon application of electrical energy.
  • the present disclosure provides an electrode adapted to connect to an electrosurgical instrument.
  • the electrode includes a proximal end that is adapted to connect to an electrosurgical instrument and an electrosurgical energy source.
  • the electrode includes a distal end configured for treating tissue.
  • the distal end of the electrode includes a first portion having one or more edges and a second portion having a substantially blunt profile.
  • An insulative material is disposed over at least the distal end of the electrode.
  • the insulative material includes a first thickness at the first portion and a second thickness at the second portion, wherein upon activation, the insulative material disposed over the first portion breaks away from the first portion allowing energy to travel to tissue from the first portion.
  • the present disclosure provides a method not a part of the invention for performing an electrosurgical procedure.
  • the method includes providing an electrosurgical system that includes an electrode that includes an insulative coating.
  • a step of the method includes positioning the electrosurgical electrode adjacent a tissue site.
  • the method includes transmitting an initial command signal to an electrosurgical generator in operative communication with the electrosurgical system.
  • the method includes transmitting an RF pulse to the electrode in response to the initial command signal, such that at least a portion of the insulative coating is removed.
  • another step of the method includes transmitting RF electrosurgical energy to the electrosurgical electrode such that an electrosurgical effect is achieved at the tissue site.
  • FIG. 1 is a side, perspective view of an electrosurgical system including an electrosurgical electrode in accordance with an embodiment of the present disclosure
  • FIG. 2 is an enlarged view of the area of detail of the electrosurgical electrode illustrated in FIG. 1 ;
  • FIG. 3 is a cut-away, cross-sectional view taken along line segment 3-3 of FIG. 2 ;
  • FIG. 4 is an electrosurgical electrode configured for use with the electrosurgical system of FIG. 1 in accordance with an alternate embodiment of the present disclosure
  • FIG. 5 is a cut-away, cross-sectional taken along line segment 5-5 of FIG. 4 ;
  • FIG. 6 is a flow chart illustrating steps for performing an electrosurgical procedure in accordance with an embodiment of the present disclosure.
  • FIGS. 7A and 7B are cross-sectional views illustrating various electrode configurations.
  • distal refers to that portion which is further from the user while the term “proximal” refers to that portion which is closer to the user or surgeon.
  • FIG. 1 sets forth a side, perspective view of an electrosurgical system including an electrosurgical pencil 100 including an electrosurgical electrode 10 constructed in accordance with one embodiment of the present disclosure. While the following description will be directed towards electrosurgical pencils it is envisioned that the features and concepts (or portions thereof) of the present disclosure can be applied to any electrosurgical type instrument, e.g., forceps, suction coagulators, vessel sealers, wands, etc.
  • electrosurgical type instrument e.g., forceps, suction coagulators, vessel sealers, wands, etc.
  • electrosurgical pencil 100 includes an elongated housing 102 having a top-half shell portion 102a and a bottom-half shell portion 102b. Electrosurgical pencil 100 includes a blade receptacle 104 disposed at a distal end of housing 102 configured to operatively and removably connect to a replaceable electrosurgical electrode 10. Electrosurgical pencil 100 may be coupled to a conventional electrosurgical generator "G" via a plug assembly 200. Electrosurgical pencil 100 includes one or more activation switches (three activation switches 120a-120c are shown). Each activation switch 120a-120c controls the transmission of RF electrical energy supplied from generator "G" to electrosurgical electrode 10.
  • electrosurgical pencil 100 including operative components associated therewith, reference is made to commonly-owned United States Patent Publication No. 2006/0178667 .
  • Electrode 10 may be fabricated from a conductive type material, such as, for example, stainless steel, or may be coated with an electrically conductive material. Electrode 10 may include any suitable configuration including but not limited to a hook, needle, loop, blade, wand, etc. In the embodiment illustrated in FIGS. 1-5 , electrode 10 includes a generally hook or "L" shape with a generally circular cross-section that extends from a proximal end 14 of electrode 10 to a distal end 12 of the electrode 10.
  • Electrode 10 includes a layer of insulative coating 18 that coats distal end 12 and/or proximal end 12.
  • the layer of insulative coating 18 may be applied evenly over the entire surface of electrode 10.
  • insulative coating may be applied in a non-even fashion.
  • electrode 10 may include portions (e.g., areas that are intended to emanate electrosurgical energy to a tissue site) that have less insulative coating 18 than other areas of the electrode 18 (e.g., areas that are not intended to emanate electrosurgical energy to a tissue site).
  • electrode 10 may include an arcuate cutout 32 that includes a thicker layer of insulative coating 18 and edges 32 that include a thinner layer of insulative coating 18.
  • This configuration of electrode 10 includes an uneven layer of insulative coating 18 that facilitates and/or speeds up the breakdown of insulative coating 18 at or near edges 32.
  • Insulative coating 18 may be made from any suitable material including but not limited to Teflon®, Teflon® polymers, silicone and the like.
  • electrode 10 operatively and removably connects to blade receptacle 104.
  • proximal end 14 is selectively retained by receptacle 104 within the distal end of housing 102.
  • an articulating portion 16 extends from proximal end 14 and operably connects distal end 12 and proximal end 14 to each other, see FIGS. 2 and 4 . The articulating portion 16 allows a user to substantially fix the distal end 12 of electrode 10 in a desired position prior to electrosurgically effecting tissue.
  • Distal end 12 of electrode 10 extends distally beyond receptacle 104.
  • Distal end 12 includes inner and an outer faces 12a and 12b, respectively.
  • Distal end 12 includes an elongated shaft portion 20 having a proximal end 22 that extends from a distal end 24 of the articulating portion 16.
  • shaft portion 20 is disposed parallel with respect to a longitudinal axis "A" of the electrosurgical pencil 100, as best seen in FIG. 2 .
  • Distal end 12 includes a curved portion 26 that extends from a distal end 28 of the shaft 20.
  • Curved portion 26 includes a generally concave configuration. In certain instances, this concave configuration may facilitate manipulating tissue. Curved portion 26 includes a generally circular cross-section.
  • a distal end 40 of curved portion 26 includes a tip 30. In the embodiments illustrated in FIGS. 1-3 , tip 30 includes a generally rounded, blunt tip configuration. Conversely, tip 30 may include a generally pointed, sharp tip configuration. Specific tip configurations of tip 30 will depend on the contemplated uses of a manufacturer.
  • An arcuate cutout 32 extends along the inner face 12a from the tip 30 of the curved portion 26 to the distal end 28 of the shaft 20, as best seen in FIG. 2 .
  • the arcuate cutout 32 may extend from the tip 30 to the distal end 24 of articulating portion 16 (see FIG. 4 , for example).
  • the specific configuration of arcuate 32 with respect to the distal end 12 and/or shaft 20 will depend on the contemplated surgical purposes of the instrument 10.
  • the arcuate cutout 32 can be extended or reduced along a length of the inner face 12a such that a specific electrosurgical effect can be achieved at a desired location along the inner face 12a.
  • Arcuate cutout 32 extends along the inner face 12a and defines one or more edges 34. In the embodiment illustrated in FIG. 2 , arcuate cutout 23 defines two relatively sharp edges 34.
  • the combination of arcuate cutout 32 and edges 34 provides at least a portion of the distal end 12 of the electrode 10 that includes a region of insulative coating 18 that is configured to provide a path for electrosurgical energy to flow from the distal end 12 of the electrode 10 to tissue during an electrosurgical procedure. More particularly, when electrosurgical energy is transmitted (e.g., in response to an initial command signal) to the distal end 12 of the electrode 10, the edges 34 provide an area of high concentration of electrosurgical energy along the length of the edge 34.
  • edges 34 This high concentration of electrosurgical energy breakdowns or "blows off" the layer of insulative coating 18 that electrically insulates the edges 34, which, in turn, provides one or more paths "P 1 " for RF energy to flow, see FIG. 3 .
  • the sharpness of edges 34 is directly proportional to the concentration of electrosurgical energy at the edges 34 when electrosurgical energy is transmitted to the electrode 10. That is, the sharper the edges 34 for a given amount of transmitted electrosurgical energy the higher the concentration of electrosurgical energy at the edges 34 when electrosurgical energy is transmitted to the electrode 10.
  • the sharpness the edges 34 relative to the arcuate cutout 32 will depend on the contemplated uses of a manufacturer.
  • Electrode 10 including distal end 12 and proximal end 14 may be formed by any suitable techniques, e.g., machining techniques.
  • distal end 12 including arcuate cutout 32 and/or sharp edges 34 may be formed by known milling techniques.
  • arcuate cutout 32 and/or sharp edges 34 may be formed by known etching techniques.
  • Electrode 200 is substantially similar to electrode 10. Accordingly, only those features and/or operative components that are unique or distinctive to electrode 200 will be described herein.
  • electrode 200 includes a pair of arcuate cutouts 232 that extend along both an inner face 212a and outer face 212b from a tip 230 of the curved portion 226 to the proximal end 222 of the shaft 220. More particularly, arcuate cutouts 232 extend along both the inner face 212a and outer face 212b and define one or more edges 234. In the embodiment illustrated in FIG. 4 , arcuate cutouts 223 define four relatively sharp edges 234.
  • arcuate cutouts 232 and edges 234 provides at least a portion of the distal end 212 of the electrode 200 that includes a region of insulative coating 218 that is configured to provide a path for transmitting electrosurgical energy from the distal end 212 of the electrode 200 to tissue during an electrosurgical procedure. More particularly, when electrosurgical energy is transmitted to the distal end 212 of the electrode 200, the edges 234 provide an area of high concentration of electrosurgical energy along the length of the edge 234. This high concentration of electrosurgical energy breakdowns or "blows off" the layer of insulative coating 218 that electrically insulates the edges 234, which, in turn, provides one or more paths "P 2 " for RF energy to flow, see FIG. 5 .
  • edges 234 the sharpness of edges 234 is directly proportional to the concentration of electrosurgical energy at the edges 234 when electrosurgical energy is transmitted to the electrode 200. That is, the sharper the edges 234 the higher the concentration of electrosurgical energy at the edges 234 when electrosurgical energy is transmitted to the electrode 200.
  • Electrosurgical pencil 100 and/or generator “G” may be set to an initial insulation "breakdown” mode setting.
  • a user may position the curved portion 26 of electrode 10 adjacent a tissue site.
  • One or more of the activation switches 120a-120c may be employed to transmit an initial command signal to the generator "G" (step 504).
  • generator "G” may be configured to transmit an initial RF pulse that is configured to breakdown or "blow-off” the insulative coating 18 located at or adjacent the one or more edges 34 (step 506).
  • initial RF pulse that is configured to breakdown or "blow-off” the insulative coating 18 located at or adjacent the one or more edges 34.
  • only the insulative coating 18 located at or near the edges 34 is broken-down, and the insulative coating 18 located on the other areas (e.g., arcuate cutout 32) on the electrode 10 remain in tact.
  • one or more of the activation switches 120a-120c may be employed to transmit a subsequent command signal to the generator "G" (step 508).
  • generator "G” may transmit RF electrosurgical energy to the electrode 10 which emanates from the one or more edges 34 such that an electrosurgical tissue effect may be achieved at the tissue site (step 510). It is contemplated that one skilled in the art will appreciate other methods of use for electrode 10 not a part of the invention.
  • electrode 10 may include other geometrical configurations. More particularly, FIGS. 7A and 7B are cut-away views illustrating other various electrode 10 configurations including their associated paths "P 3 " and "P 4 " for RF energy to flow not part of the invention.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Otolaryngology (AREA)
  • Neurology (AREA)
  • Biomedical Technology (AREA)
  • Neurosurgery (AREA)
  • Plasma & Fusion (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Claims (7)

  1. Elektrode (200), die angepasst ist, sich mit einem elektrochirurgischen Instrument (100) zu verbinden, die Elektrode mit:
    einem proximalen Ende (14, 214), das angepasst ist, sich mit einem elektrochirurgischen Instrument (100) und einer elektrochirurgischen Energiequelle ('G') zu verbinden und einem distalen Ende (12a, 12b, 212a, 212b), das zum Behandeln von Gewebe eingerichtet ist, wobei das distale Ende der Elektrode einen ersten Abschnitt mit mindestens einer Kante (34, 234) und einen zweiten Abschnitt (30, 230) an der Spitze, die ein im Wesentliches stumpfes Profil aufweist, einschließt; und
    einem Isolationsmaterial (18, 218), das zumindest über dem distalen Ende der Elektrode angeordnet ist, wobei bei Aktivierung das über dem ersten Abschnitt angeordnete Isolationsmaterial von dem ersten Abschnitt abbricht und zulässt, dass von dem ersten Abschnitt Energie zu dem Gewebe läuft,
    wobei das distale Ende eine bogenförmige Aussparung (32, 232) aufweist und wobei die bogenförmige Aussparung zwei Kanten definiert, die die mindestens eine Kante einschließt, die eingerichtet ist, das Isolationsmaterial abzubrechen,
    wobei die bogenförmige Aussparung eine dickere Schicht aus Isolationsmaterial aufweist und die Kanten eine dünnere Schicht aus Isolationsmaterial aufweisen,
    wobei das distale Ende der Elektrode hakenförmig und/oder L-förmig ist, und
    wobei sich die bogenförmige Aussparung (32, 232) entlang einer inneren Fläche (12a, 212a) des distalen Endes (212a/b) erstreckt.
  2. Elektrode nach Anspruch 1 oder 2, bei der das Isolationsmaterial eine erste Dicke bei dem ersten Abschnitt und eine zweite Dicke bei dem zweiten Abschnitt aufweist, wobei die erste Dicke des Isolationsabschnitts zwischen in etwa 0 bis in etwa 0,002 Inch (0 bis 0,05 mm) beträgt und die zweite Dicke des Isolationsabschnitts von in etwa 0,003 bis in etwa 0,005 Inch (0,08 bis 0,1 mm) beträgt.
  3. Elektrode nach einem der vorstehenden Ansprüche, wobei das distale Ende der Elektrode eine innenseitige Fläche aufweist.
  4. Elektrode nach einem der vorstehenden Ansprüche, wobei das distale Ende der Elektrode eine außenseitige Fläche aufweist.
  5. Elektrode nach einem der vorstehenden Ansprüche, wobei die Elektrode des Weiteren einen Gelenkabschnitt aufweist.
  6. Elektrode nach Anspruch 5, bei der sich die bogenförmige Aussparung von einer Spitze (230) des distalen Endes zu dem Gelenkabschnitt der elektrochirurgischen Elektrode erstreckt.
  7. Elektrode nach einem der vorstehenden Ansprüche, bei der die elektrochirurgische Elektrode durch einen aus Fräsen und Ätzen ausgewählten Prozess ausgebildet ist.
EP10175050A 2009-09-02 2010-09-02 Elektrochirurgische Elektrode mit Isolierbeschichtung Not-in-force EP2292172B1 (de)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
US12/552,397 US8398625B2 (en) 2009-09-02 2009-09-02 Electrosurgical electrode with insulative coating

Publications (2)

Publication Number Publication Date
EP2292172A1 EP2292172A1 (de) 2011-03-09
EP2292172B1 true EP2292172B1 (de) 2012-12-19

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US (1) US8398625B2 (de)
EP (1) EP2292172B1 (de)
JP (1) JP2011050743A (de)
CA (1) CA2714202A1 (de)

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Also Published As

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US8398625B2 (en) 2013-03-19
JP2011050743A (ja) 2011-03-17
US20110054461A1 (en) 2011-03-03
EP2292172A1 (de) 2011-03-09
CA2714202A1 (en) 2011-03-02

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